Lauren Grunebaum L.C.S.W.

Searching for the Magic Wand

Anxiety is inherent in recovery. There is no magic wand.

As tortuous and tormenting as anorexia is, the sufferer often feels ambivalent about recovery, if not consciously, then unconsciously. She may not be able to acknowledge nor admit to the part of her that fears living without her eating disorder. I am reminded of my own conflicting feelings when I sit with my clients who now struggle with similar emotions.

Anorexia is a debilitating illness, yet it serves many purposes and plays an important role in the sufferer's defense system. It can be a way to express anger, anxiety, and sadness and a way to avoid feeling these same uncomfortable emotions. In a stressful and constantly changing environment, such as at times of separating from family, the rigidity of the illness feels safe, like a security blanket. The sufferer becomes accustomed to the restrictions imposed by the illness. It simultaneously feels like one's best friend and worst enemy.

The ambivalence splits the sufferer in two. One side wants to free herself from the physiological and emotional starvation, from the anorexia, an illness which consumes all of one's life, leaving no space for anything nor anyone else. Another part of the self clings desperately to the illness, terrified to give up what it knows best, what feels safe and from what often provides the sufferer with a false sense of control, success, and mastery. The sufferer feels an internal war with the two sides fighting each other. It is a battle from which there feels like no escape. The sufferer is tormented and feels like she is in a no-win situation.

Ambivalence about recovery comes in many forms and has many voices. One way the ambivalence gets expressed is through what I call searching for the magic wand. This is often played out in the person's therapy. It occurs after the sufferer has begun to trust and feel safe with her therapist, willing to show some of her vulnerability. It is at this point that I, as a therapist, may begin to question my client's false assumptions and rigid behaviors. Together we try to explore alternative ways to help her to express and to deal with her feelings, ways that are constructive not self-destructive.

I may ask my client if she is truly in control of her eating. If so, why is she on a path of self-destruction? It is more likely that the anorexia has taken on a life of its own and is in control of her. How does she feel about her low energy level and difficulty in concentrating? Why is it that she spends much of her time obsessing about what she will or will not eat? How does she feel when her rigid and restrictive eating patterns isolate her from her friends? Is this what she wants the rest of her life to look like? Several of my clients in their mid-twenties tell me they want to have children. I ask them how is that possible when they are no longer menstruating. I pose these questions slowly and over time. There is a fine line between challenging the sufferer and overwhelming her.

As eager and committed to recovery as the client is, the questioning and probing of her anorexic mindset and behaviors stirs up great anxiety, the very feeling she has desperately tried to avoid. She is in a quandary. How can she placate both sides? How can she honor her commitment to recovery while at the same time avoid her anxiety by remaining anorexic?

It is at this point that the sufferer may think of looking for a new therapist, one who can help her recover without feeling anxious, a therapist who has a magic wand. Unfortunately, anxiety is inherent in the process of recovery. There is no way to escape it. There are ways to learn to tolerate it and cope with it in a constructive, not self-destructive way.

As I sit with my client through her anxiety, she learns that this feeling is not permanent and is more like a wave. It peaks and then descends and if we work together, she can tolerate it. Together we also explore tools such as mindfulness, journaling, cognitive behavioral therapy, yoga, all of which can help her to deal with what can feel like unbearable anxiety. As I learned myself and as I now tell my client, learning to tolerate anxiety and integrating new tools for coping with it requires tenacity, persistence, and patience. Yet it is possible. Eventually and with much practice, the hope is that the client will be able to use these tools at other times of anxiety throughout her life, one that is much richer without the chains of the anorexia.